Primary Retinal Detachment
Primary Retinal Detachment
Primary Retinal Detachment
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the operating table with the retina still detached, in contrast to<br />
the one after drainage or the injection of a gas bubble after<br />
drainage, in which case the retina is already attached at the<br />
table. Following such an operation, the surgeon can feel relaxed<br />
and, as often said,“sleep better.” However, the secrets of success<br />
with nondrainage are: first, the surgeon has to be convinced<br />
that all of the breaks have been found and tamponaded sufficiently,<br />
and, second, a spontaneous attachment on the next day<br />
will confirm that all of the breaks were found and tamponaded<br />
sufficiently. However, this will be the case only in retrospect, i.e.,<br />
hours after surgery combined with postoperative concern on<br />
the part of the surgeon. However, by performing drainage, often<br />
explained as being done for the sake of the surgeon or the patient,<br />
the retina might be attached at the table only temporarily,<br />
due to the drainage alone.<br />
As a consequence, the “conditio sine qua non” for spontaneous<br />
attachment after nondrainage is that all of the leaking breaks have<br />
been found and tamponaded sufficiently intraoperatively. Otherwise,<br />
the spontaneous or “magic” disappearance of subretinal fluid<br />
will not occur. Other questions were:<br />
3. Will a buckle that is unsupported by an encircling band persist?<br />
4. Is the prophylactic value of a cerclage needed for long-term<br />
retinal attachment?<br />
Minimal Segmental Buckling With Sponges and Balloons<br />
Without Drainage (Extraocular Minimal Surgery)<br />
Specifics<br />
6 Minimal Segmental Buckling With Sponges and Balloons<br />
This surgery is derived from the cryosurgical detachment operation<br />
of Lincoff, introduced in 1965 [16], which brought about two<br />
major changes: (1) the change from intraocular to extraocular<br />
surgery, since drainage of subretinal fluid was omitted and (2)<br />
the change from a surgery of the detachment to a surgery of the